88235 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 88235

Payer coverage policies that name 88235

88235 appears in 6 coverage policies from Aetna, Blue Cross NC, Cigna.

PayerPolicyRole in policyReviewedDocument
AetnaRecurrent Pregnancy Loss (0348)covered if criteria are met (range 88230-88239)Jun 23, 2026payer document
AetnaTumor Chemoresistance Assays (0758)listed, no stanceDec 2, 2025payer document
AetnaTumor Chemosensitivity Assays (0245)listed, no stanceApr 13, 2026payer document
Blue Cross NCMaternal and Fetal Diagnosticslisted, no stanceMar 1, 2026payer document
Blue Cross NCPrenatal Testing for Fetal Aneuploidy AHS - G2055listed, no stanceJan 1, 2026payer document
CignaLaboratory Testing Services (0604)not coveredMay 15, 2026payer document

Medicaid fee-for-service

  • AZ: $150.30 (lab), effective Oct 1, 2026
  • CO: $150.30 (lab_cdl), effective Oct 1, 2025
  • FL: $101.04 (lab_independent, non-facility), effective Jan 1, 2026
  • IL: $133.60 (practitioner), effective Jul 1, 2026
  • IN: $127.75 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2024
  • KS: $95.82 (default, Exempt Physician), effective Jul 1, 2023
  • KY: $150.30 (lab), effective Jan 1, 2026
  • LA: $127.76 (lab_radiology), effective Jul 1, 2025
  • MS: $135.27 (comprehensive), effective Jul 1, 2026
  • ND: $150.30 (physician), effective Aug 1, 2026
  • NE: $150.30 (lab), effective Jul 1, 2026
  • NY: $133.23 (lab), effective Aug 1, 2026
  • OH: $112.72 (lab), effective Apr 1, 2021
  • OK: $133.69 (physician, non-facility), effective Jul 1, 2026
  • VA: $41.80 (medical), effective Jul 1, 2014
  • VT: $146.54 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $120.24 (kidneycenters), effective Jul 1, 2026
  • WY: $0.00 (outpatient_hospital_apc, Children's Hospitals), effective Apr 1, 2026

From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.